New review: comparison global calcium intake

Many countries in Southeast Asia have an average intake of calcium lower than 500 mg/day

28 November 2017

The calcium intake of adults around the globe has been systematically reviewed by the International Osteoporosis Foundation. Key findings are that calcium intake varies across countries ranging from 400 to 500 mg/day in countries in South, East and Southeast Asia to 1233 mg/day in Iceland.

Calcium is the most common mineral in our bodies. There is scientific proof that the human body needs sufficient amounts of calcium in our nutrition. This is relevant for every phase in life, both old and young. Calcium supports the building-up of bone mass in children (1,2,3). Calcium also contributes to the maintenance of bones, normal blood clotting, neurotransmission and proper functioning of muscles. (1)

Given these functions of calcium, it is relevant to have insight in which countries have lower calcium intakes. The calcium steering committee of the International Osteoporosis Foundation therefore systematically reviewed the calcium intake among healthy adults around the globe. The researchers Balk et al (2017) (4) selected per country one or two most representative studies. Studies including national (or regional) survey data among the general population (>18 years old) and reporting average dietary calcium intake (since 2010) were included in the analysis. After the selection there were 78 representative studies involved, covering 74 countries. (4)

Variation between countries

The researchers found that the average calcium intake varies across countries. The lowest calcium intake was found in Asia, amongst others in Thailand* (313 mg/day), China* (338 mg/day), Indonesia* (342 mg/day), Vietnam* (345 mg/day) Malaysia* (399 mg/day) and Philippines* (440 mg/day). Compared to other Asian countries, higher average calcium intake was found in Singapore (794 mg/day).

All countries in Europe that were included in the review have a calcium intake higher than 700 mg/day. It varied amongst others between Belgium (728 mg/day), the United Kingdom* (994 mg/day) and the Netherlands* (1102 mg/day). The highest calcium intake was found in Iceland* (1233 mg/day), however, this study in Iceland also includes the use of dietary supplements. (4)

Variation between age groups

Beside the results Balk and colleagues (2017) it is known from country specific intake data that the calcium intake can vary between subgroups (i.e. adolescents compared with adults or elderly); for example teenage girls in the Netherlands and the United Kingdom have lower calcium intakes compared with the calcium recommendations for this specific age group. (5,6)

Conclusion

This research of Balk et al (2017) shows that the calcium intake is low (< 500 mg/day) in many countries in South, East and Southeast Asia. Lower calcium intake can adversely effect on bone health in adults. According to the researchers it is a public health priority to increase the calcium intake in those countries. Moreover, the calcium intake has not been reported in over half of the world’s population. This research of Balk et al (2017) draws attention to assess and monitor the calcium intake, especially in countries with low calcium intake or countries were calcium intake data is lacking. (4)

Figure adapted from Balk et al (2017).

*as mentioned by Balk et al (2017), the researchers found that three quarter of the calcium intake studies in their analysis were not nationally representative, were based on old surveys, or of a lower quality regarding the methodology. Also different methods were used to assess the calcium intake. Therefore these intake numbers need to be interpret with caution (4)